Rancho Los Amigos Medical Center - A unique orthopaedic resource and teaching institution

Rancho Los Amigos Medical Center, initially a poor farm in the County of Lo s Angeles, CA became a world renown medical institution because of the poli o epidemics in the 1950s. Responding to the need for day to day inpatient c are were an overflow of victims of polio who had spine and extremity weakne ss and were dependent on respirators. Team care, developed at the instituti on, was used by Vernon L. Nickel, chief orthopaedic surgeon so that maximum use of the limited staff's efforts would be to take care of patients. This need spawned many innovative developments through clinical observations an d trials, basic research, and engineering innovations that resulted in the patient's functional improvement and helped return many victims of polio to independence and to their communities. Subsequently, orthopaedic surgeons, Jacquelin Ferry, and Alice Garrett joined the full-time staff as the workl oad increased. Stabilizing the spine using fascial supports, spinal fusion, spinal instrumentation, orthoses, and seating systems allowed those patien ts who were not totally dependent on respirators to be upright and mobilize d. When polio was eradicated, newer programs were established for physicall y disabled persons with musculoskeletal disorders affecting the spine and e xtremities and for those patients with congenital, acquired, neurologic, an d neuromuscular disorders. In formal graduate residency affiliations, fello wships, and continuing medical education programs orthopaedic surgeons from around the world have been taught the basic principles of "categorical car e" for physically disabled people for 50 years. Orthopaedic care given thro ugh these programs formed the basis of a new orthopaedic subspecialty, Orth opaedic Rehabilitation.